Attitude towards cadaver demonstration among irst-year dental students

Sneka S1, Yuvaraj Babu K*2, Gayatri Devi R3 1Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India 2Department of Anatomy, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India 3Department of Physiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India


INTRODUCTION
Anatomical demonstration is one of the most important parts in learning and understanding Anatomy It is considered as essential requirements in learning gross anatomy. It plays an important role in shaping medical and dental students (Chang et al., 2018). Anatomy is the fundamental of medical and dental education. Anatomic demonstration enables the examination of the organs in humans systematically and topographically (Bati et al., 2013). Today there is a worldwide move of anatomy based teaching from dissection from prossection (Snelling et al., 2003). Undergraduate medical and dental students in India go through extensive anatomy teaching by demonstration (Arora and Sharma, 2011). If a student wants to become a doctor, they should be completely aware of where the artery, nerve runs and also they should be aware of the position and function of organs. And hence anatomy is one of the exciting subjects which deals with the function of organs and also positions of organs (Darras et al., 2019). Formalin is used to preserve cadaver, especially in the ield of medicine for study purposes. But it has many harmful effects in an individual body that depends on the time they are in contact with formalin (Mwachaka et al., 2016). In cadaver demonstration, students will be exposed to the anatomic relationship of the major organ sys-tems of the body and how those organ systems can relate to various human diseases. Cadaver demonstration is important for surgeons to acquire fundamental scienti ic knowledge is a critical necessity in clinical examination of patients, diagnosis of disease and consultation with other medical personnel (Rajeh et al., 2017). During recent years, the use of human dissection or demonstration as a learning tool has come under controversy and also cadaver demonstration is considered as a tool for studying the structural detail of the human body (Menon and Thenmozhi, 2016). It has been well reported that the emotional experience of medical students in the gross anatomy laboratory could have significant impacts on their professional identi ication. The main ethical concern of cadaver demonstration lies in respect to human life. The students in our country have an enormous opportunity to dissect cadaver and learn about themselves where there are morgues for medicolegal autopsy purposes. (Nandhini et al., 2018;Subashri and Thenmozhi, 2016) Demonstration is the act of showing something which exists is true by giving proof, or evidence Cadaver demonstration also shows students the practical examination, which makes them easily understood. (Kannan and Thenmozhi, 2016;Keerthana and Thenmozhi, 2016;Pratha and Thenmozhi, 2016) This study is to know the anxiety level of students during the demonstration. And hence the aim of this study is to assess the attitude of the irst year dental students towards cadaver demonstration.
Over the past years various research done by our team was on osteology (Choudhari and Thenmozhi, 2016;Hafeez and Thenmozhi, 2016) stature estimation (Krishna and Babu, 2016) use and ill effects of electronic gadgets (Sriram et al., 2015;Thejeswar and Thenmozhi, 2015) on RNA (Johnson et al., 2020;Sekar et al., 2019) Animal studies (Seppan et al., 2018) and in few other ields (Memon, 2018). There is a lack of much information on the current topic of attitude towards cadaver demonstration. Hence, the aim of this study is to assess the attitude of the irst year dental students towards cadaver demonstration. (Samuel and Thenmozhi, 2015)

Study design
A cross-sectional survey was conducted among irstyear dental students to evaluate the attitude of the students towards cadaver demonstration. The study population are the irst-year dental students with a sample size of 100. The participants did the survey voluntarily and no incentives were given to them. The study was conducted in May 2020. Ethical approval and informed consent from the participants were obtained

Survey instrument
The questions were prepared after extensive review of existing literature.
The questionnaire was reviewed and amendments were made to improve the clarity of pertinent questions and eliminate ambiguous responses. The survey instrument was a structured questionnaire with both open and close-

Data analysis
Only illed online forms were included in the study. The illed responses were veri ied by two reviewers and the collected data was entered on the same day. The entered data analysed using SPSS statistics 19. As a version used for statistical analysis. Descriptive statistics were performed to calculate frequencies of categorical variables as pie-charts.

RESULTS AND DISCUSSION
Out of 100 participants, 73% of the students have seen cadaver before and 26% of the students had never seen a cadaver before (Figure 1) 61% of the students have a pleasant feeling before entering the demonstration hall and 36% of them does not have a pleasant feeling (Figure 2). 34% of the students were anxious while seeing cadaver; 39% of the students were fearful while seeing cadaver, whereas 26% of the students were normal (Figure 3). 58% of the students liked to hold the bone and 41% of the students did not like to hold the bone (Figure 4). 54% of the students have the thought of leaving the course for cadaveric experience and 45% of the students do not have the thought of leaving the course for cadaveric experience ( Figure 5). 52% of the students have apprehension in handling the cadaver directly, whereas 47% of the students do not apprehend in handling the cadaver directly ( Figure 6). 66% of the students think that personal equipment is necessary for demonstration and 33% of the students do not think that personal equipment is necessary for demonstration (Figure 7). 63% of the stu- dents will wear gloves when they touch the cadaver and 35% of the students do not wear gloves (Figure 8). 66% of the students experience the formalin odour and 33% of the students do not experience the formalin odour (Figure 9). 59% of the students felt some physiological effects and 40% of the students have never felt a physiological effect (Figure 10). 52% of the students have been affected with a disease and 47% of the students answered no (Figure 11). 68% of the students think that demonstration enhances the skill of thinking and 31% of the students answered no (Figure 12). 64% of the students answered that cadaver demonstration is better than dissection, whereas 35% of the students answered no (Figure 13). 55% of the students said that cadaver demonstration is useful in dentistry and 43% of the students said that cadaver demonstration is useful in medicine (Figure 14). 65% of the students answered that cadaver demonstration is ethically acceptable and 34% of the students said that cadaver demonstration is not acceptable (Figure 15). 65% of the students said that cadaver demonstration is highly used in medical, whereas remaining students answered dental ( Figure 16). 61% of the students respect cadaver remaining 38% of the students do not respect cadaver ( Figure 17). 75% of the students have a sense of gratitude towards people who donate their  When compared to other studies, around 76% of the agreed that demonstration enhances the skill of thinking (Izunya, 2010). Whereas in this study, 68.69% of the students agreed that demonstration enhanced the skill of thinking and the remaining 31% of them answered no. The results are almost the same in both studies. In another article, 84% of them said that they like to hold the bone and 6% of them answered no (Saha and Moirangthem, 2015). Whereas in this study, 58% of them said that they like to hold bone remaining 41% of them answered no. When compared to another article, 99% of them said cadaver demonstration is important (Mulu and Tegabu, 2012) Whereas in this study 55% of them answered yes and the remaining 43% of them answered no. The results are different from the previous study, as the population involved is limited in this study.
Future study can change the attitude of the students Figure 1, 73% of the students had seen cadaver before while 26% of the students had never seen a corpse before Figure 2, 61% of the students had a pleasant feeling before entering the demonstration hall while 36% of them did not have pleasant feelings Figure 3, 34% of the students were anxious while seeing cadaver,39% of the students were fearful while seeing cadaver whereas 26% of the students were normal Figure 4, 58% of the students liked to hold the bone whereas 41%of the students did not like to hold the bone Figure 5, 54% of the students had the thought of leaving the course due to cadaveric experience whereas 45% of the students did not have the thought of leaving the course for cadaveric experience Figure 6, 52% of the students had apprehension in handling the cadaver directly whereas 47% of the students did not have apprehension on handling the cadaver directly Figure 7, 66% of the students thought that personal equipment was necessary for demonstration while 33% of the students did not think that personal equipment was necessary for demonstration Figure 8, 63% of the students were ready to wear gloves when they touch the cadaver while 35% of the students did not want to wear gloves Figure 9, 66% of the students experienced formalin odour whereas 33% of the students did not experience formalin odour Figure 10, 59% of the students felt some physiological effects whereas 40% of the students did not feel any physiological effect Figure 11, 52.5% of the students had been affected by a disease, whereas 47.5% of the students were not affected Figure 12, 68.69 % of the students thought that demonstration enhances the skill of thinking, whereas 31% of the students did not think so Figure 13, 64% of the students answered that cadaver demonstration was better than dissection whereas 35% of the students answered no Figure 14, 56% of the students said that cadaver demonstration was useful in dentistry whereas 44% of the students said that cadaver demonstration is useful in medicine Figure 15 , 65.5 % of the students answered that cadaver demonstration is ethically acceptable while 34.5 % of the students said that cadaver demonstration was not acceptable Figure 16, 65% of the students said that cadaver demonstration is highly used in medical whereas the remaining 36% of the students answered highly useful in dental Figure 17, 61.6% of the students respected cadaver whereas remaining 38.3% red of the students did not respect cadaver Figure 18, 75% of the students have a sense of gratitude towards people who donate their bodies whereas20% of the students answered no Figure 19, Pearson's Chi Square value:2.284, P value:0.131 (> 0.005), Statistically not signi icant. The bar graph reveals the association between gender and X-axis represents the gender and Y-axis represents Attitude regarding pleasant feeling before entering the demonstration hall, the number of participants responding. Chi Square test was done and the association was found to be statistically nonsigni icant The bar graph reveals the association between gender and attitude while seeing cadaver. The X-axis represents the gender and Y-axis represents the number of participants responding to their attitude while seeing the cadaver Chi Square test was done and the association was found to be statistically nonsigni icant Figure 21, Pearson's Chi Square value: 0.055, P value:0.814(>0.005), Statistically not signi icant. The bar graph reveals the association between gender and holding bone X-axis represents the gender and Y-axis represents the number of participants' attitude regarding holding bone Chi Square test was done and the association was found to be statistically non-signi icant Figure 22, Pearson's Chi Square value: 0.113, P value:0.736 (>0.005), Statistically not signi icant. The bar graph reveals the association between gender and students thought of leaving the course. The X-axis represents the gender and Y-axis represents the number of participants' response to leave the course, Chi Square test was done and the association was found to be statistically non-signi icant Limitations include small population, homogenous population. The biased response could do in a large population, heterogeneous.

CONCLUSIONS
This study helps in knowing the attitude of irstyear dental students towards cadaver demonstration. From this study, it has been concluded that cadaver demonstration enhances the skill of thinking in a logical manner and also cadaver demonstration gives better results than cadaver dissection.